Eating vegetables first: the use of portion size to increase vegetable intake in preschool children

Spill, Maureen; Birch, Leann L.; Roe, Liane S.; Rolls, Barbara J.

doi:10.3945/ajcn.2009.29139

Cited by 106 publications

(106 citation statements)

References 37 publications

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“…When 44 intervention arms within studies were used as the unit of analysis, a slightly higher effect size was observed g = 0.42, CI: 0.33-0.51, Z = 8.79, p < 0.001. The sensitivity analyses performed by excluding three studies (Bell et al, 2015;Harnack et al, 2012;Spill et al, 2010) …”

Section: Synthesis Of Results: Meta-analysismentioning

confidence: 99%

“…For studies with more than one intervention group, the intervention arm (condition) was used as the unit of analysis. Sensitivity analysis was performed by excluding three studies, one which reported median data (Bell, Hendrie, Hartley, & Golley, 2015), another with various experimental conditions but none were defined as standard or control condition (Spill, Birch, Roe, & Rolls, 2010) and a third study by Harnack et al (2012) who found non-significant effects for one of their intervention arm but did not report the precise p value (p value of > 0.05 was entered as 0.06). Subgroup analysis was conducted based on study methodology (study design, location, study setting and quality assessment ratings) and intervention factors (intervention strategies, type of vegetable, outcome measurements, delivered by and the intervention recipient).…”

Section: Gripshover Andmentioning

confidence: 99%

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Systematic review and meta-analysis of strategies to increase vegetable consumption in preschool children aged 2–5 years

et al. 2018

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specifically with measured vegetable consumption were included. Results: 30 articles and 44 intervention arms were identified for inclusion (n = 4017). Nine dominant intervention strategies emerged to promote vegetable intake in preschool children. These included; choice, pairing (stealth), education, food service, modelling, reward, taste exposure, variety and visual presentation. The metaanalysis revealed that interventions implementing repeated taste exposure had better pooled effects than those which did not. Intake increased with number of taste exposures and intake was greater when vegetables offered were in their plain form rather than paired with a flavor, dip or added energy (e.g. oil). Moreover, intake of vegetables which were unfamiliar/disliked increased more than those which were familiar/liked. Conclusions: Repeated taste exposure is a simple technique that could be implemented in childcare settings and at home by parents. Health policy could specifically target the use of novel and disliked vegetables in childcare settings with emphasis on a minimum 8-10 exposures.The systematic review protocol was registered on the PROSPERO (number: CRD42016033984).

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Section: Synthesis Of Results: Meta-analysismentioning

confidence: 99%

Section: Gripshover Andmentioning

confidence: 99%

Systematic review and meta-analysis of strategies to increase vegetable consumption in preschool children aged 2–5 years

et al. 2018

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“…If past lab studies generalize, parents may be able to covertly increase consumption of healthy foods by adjusting fruit and vegetable portions while reducing or holding entrée size constant (Kral et al 2010;Mathias et al 2012;Savage et al 2012). Other covert possibilities include serving vegetables at a meal, adding pureed vegetables to entrees, or substituting ingredients to reduce calories --these can be effective because both adults and children tend to eat the same weight of food even when calories have been reduced (Leahy et al 2008;Spill et al 2010Spill et al , 2011.…”

Section: Creating a Healthy Home Environmentmentioning

confidence: 99%

All in the Family? Parental Roles in the Epidemic of Childhood Obesity

2016

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Childhood obesity is a serious global health challenge. Families and consumption are at the nexus of the problem, as childhood weight issues depend significantly on family-related influences (genetic predispositions, physical activities, and household food consumption practices). This article focuses on how a family socializes a child toward or away from obesity. It advances a family consumer socialization framework to characterize key elements and processes.Biological predispositions, parent/family inputs, elements of child development, parent-child interactions, and intergenerational transfer are all major contributors to weight status and life course potentials. Time is also a crucial component, here represented in two forms --linear and cyclical. Drawing on extensive research from other disciplines and related consumer research, five "Foundational Properties" are distilled, representing fundamental tenets underpinning the family's role in this problem. Each property is then used to chart promising opportunities for consumer researchers and others interested in advancing knowledge on this pressing concern.

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“…vegetable soup) (73,74) or larger portions of fruit and vegetables with a meal (75,76) , were effective strategies in both promoting fruit and vegetable intake and decreasing the ED of children's meals. For example, in the study by Kral et al (75) when the PS of the broccoli and carrots side dish was doubled (75 g v. 150 g), children consumed significantly less of the pasta entree.…”

Section: Additive Effects Of Portion Size and Energy Density On Energmentioning

confidence: 99%

Influencing and modifying children's energy intake: the role of portion size and energy density

et al. 2014

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Childhood obesity is of concern worldwide. The portion size (PS) and energy density (ED) of food are two major determinants of children's energy intake (EI). Trends towards increasing PS are most apparent and best documented in the USA, where PS of numerous food products have increased in the marketplace over the past three decades, particularly high-energy dense foods. Analyses of population-level dietary surveys have confirmed this trend in children for both in-and out-of-home eating, and a plethora of observational evidence positively associates PS, ED and adiposity in children. A limited number of intervention studies provide clear evidence that children, even as young as 2 years, respond acutely to increasing PS, with some studies also demonstrating the additive effects of increased ED in promoting excessive EI. However, most of the evidence is based on children aged 3-6 years and there is a paucity of data in older children and adolescents. It is unclear whether decreasing PS can have the opposite effect on children's EI but recent acute studies have demonstrated that the incorporation of lower energy dense foods, such as fruit and vegetables, into children's meals down-regulates EI. Although a direct causal link between PS and obesity remains to be established, the regular consumption of larger PS of energy dense foods do favour obesity-promoting eating behaviours in children. Further research is required to establish the most feasible and effective interventions and policies to counteract the deleterious impact of PS and ED on children's EI.

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Eating vegetables first: the use of portion size to increase vegetable intake in preschool children

Abstract: Increasing the portion size of a vegetable served as a first course can be an effective strategy for increasing vegetable consumption in preschool children.

Cited by 106 publications

References 37 publications

Systematic review and meta-analysis of strategies to increase vegetable consumption in preschool children aged 2–5 years

Systematic review and meta-analysis of strategies to increase vegetable consumption in preschool children aged 2–5 years

All in the Family? Parental Roles in the Epidemic of Childhood Obesity

Influencing and modifying children's energy intake: the role of portion size and energy density

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